{
"Npi": {
"NPI": "1487096178",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ROUSE",
"FirstName": "KRISTOFFER",
"MiddleName": "JOHN ALMAZAN",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "PHD, MA, LMHC",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "ROUSE",
"OtherFirstName": "KRISTOFFER",
"OtherMiddleName": "JOHN ALMAZAN",
"OtherNamePrefix": "DR.",
"OtherNameSuffix": null,
"OtherCredential": "LMHC",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "1700 NW GILMAN BLVD STE 205",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ISSAQUAH",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98027-5364",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "206-496-6109",
"MailingAddressFaxNumber": "425-295-7637",
"FirstLinePracticeLocationAddress": "1700 NW GILMAN BLVD STE 205",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ISSAQUAH",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98027-5364",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "206-496-6109",
"PracticeLocationAddressFaxNumber": "425-295-7637",
"EnumerationDate": "07/23/2013",
"LastUpdateDate": "08/21/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YM0800X",
"TaxonomyName": "Mental Health Counselor",
"LicenseNumber": "LH60560653",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}